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兽医重症监护病房中的福利、法律与伦理:(探讨患者在兽医重症监护病房中可能遭受的不同类型的痛苦、这种痛苦的法律界限,以及支撑痛苦在何时变得“不必要”的伦理问题)

Welfare, law and ethics in the veterinary intensive care unit: (A discussion of the different types of suffering that patients may endure in the veterinary intensive care unit, the legal limits to that suffering, and the ethics underpinning at what point that suffering becomes 'un-necessary').

作者信息

Fordyce Peter S

机构信息

Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.

出版信息

Vet Anaesth Analg. 2017 Mar;44(2):203-211. doi: 10.1016/j.vaa.2016.06.002. Epub 2017 Jan 11.

Abstract

OBJECTIVES

In UK law, allowing an animal protected under the Animal Welfare Act 2006 (AWA 2006) (as devolved) to suffer 'unnecessarily' may render the person responsible for it to prosecution. The act does not define suffering, although 'case law' suggests that suffering encompasses more than pain. Clinicians responsible for animals under their care in the intensive care unit (ICU) are likely to also be responsible in law for the welfare of those animals, and may be called upon to justify why any suffering was necessary, or more likely, why they did not act to end any suffering when it became 'unnecessary'. As animals are considered to be 'property' in law, the legal requirement to prevent 'unnecessary suffering' may conflict with the owner's property rights. Additionally, professional conflict may arise between the clinicians whose opinion of where the border between 'heroic treatment' and 'futile treatment' lays. Different types of suffering that might be relevant to clinical and ethical decision making for patients in the ICU are discussed, with suggestions for how these might be categorised, measured and recorded, so that objective data is available on which discussions about the animal's actual and projected welfare can be held with the animal's owner, and other clinicians involved in the case.

CONCLUSIONS

The development of 'welfare scoring systems' for the ICU may assist clarifying the point at which heroic treatment is becoming futile, and therefore suffering becoming unnecessary, and place veterinary anaesthetists in an even stronger position to act as 'advocate for the animal' in their care.

摘要

目标

在英国法律中,允许受2006年《动物福利法》(2006年AWA,权力下放后)保护的动物遭受“不必要的”痛苦,可能会使对此负责的人受到起诉。该法案没有对痛苦进行定义,尽管“判例法”表明痛苦所涵盖的不仅仅是疼痛。在重症监护病房(ICU)负责照料动物的临床医生在法律上可能也对这些动物的福利负责,并且可能需要说明为何任何痛苦是必要的,或者更有可能的是,为何当痛苦变得“不必要”时他们没有采取行动来结束痛苦。由于动物在法律上被视为“财产”,防止“不必要的痛苦”的法律要求可能与动物主人的财产权相冲突。此外,对于“积极治疗”和“无效治疗”之间界限的看法,临床医生之间可能会产生职业冲突。本文讨论了与ICU患者临床和伦理决策可能相关的不同类型的痛苦,并就如何对这些痛苦进行分类、衡量和记录提出了建议,以便能够获得客观数据,从而与动物主人以及参与该病例的其他临床医生就动物的实际和预期福利进行讨论。

结论

为ICU开发“福利评分系统”可能有助于明确积极治疗何时变得无效,从而痛苦何时变得不必要,并使兽医麻醉师在照料动物时更有底气充当“动物的倡导者”。

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